People in healthcare should speak Spanish, she said

MunoRN, RN · Jan 10, 2011

Sorry to hear your hospital can't afford patient safety, but your comments point out that you failed to read my post:

I did actually read your post and addressed the issue of language line standards of care, see below:

Again, the evidence disagrees with you. Even with the availability of language lines, patients are safer when cared for by staff who are able to communicate directly and frequently, even at an amateur level. It is most definitely not outside your potential scope of practice; your scope of practice is any skill that you have learned and maintained that is not expressly prohibited, and as long as you are over 18, you can translate according to both my hospital policy and state law.
Language lines are great and still need to be used even by bilingual nurses, but they aren't actually the standard of care for minute to minute translation needs, only for consents and initial assessment. We have a language line where I work and we only allowed to use it for our initial shift assessment and for consents. Even then, 15% of hospitals don't use a language line at all.
Where I work, I can spend 10 hours of a 12 hour shift in one patient's room. Even if I was allowed to, is it likely that I would have the language line open that entire time? Probably not, and this is where the patient safety issue comes in. Just like patients on isolation, non-english speaking patients have poorer outcomes at least in part because we avoid them, having the ability to communicate in those situations where most nurses wouldn't use the language line, but instead just nod, smile, and slink back out of the room improves patient safety according to the evidence. Even though it is hard to disagree with someone who's views on this are self-described as "screw diversity", I'll defer to the evidence on this one.

The limitations placed on use of the Language Line at my facility was based on the Standards of Care for non-English speaking patients. Language Lines, utilizing certified Medical Interpreters, are the standard of care for an initial assessment and are a legal requirement for obtaining consent. If you use the Language Line for all your other patient interactions (which according to standards of care is at least hourly) that's great, but most nurses severely underuse Language Line resources much less use it hourly and unfortunately just tend to avoid the patient altogether, similar to an isolation patient and with the same resulting level of poorer outcomes, even though they may have unlimited access to Language Lines.

NurseAdida · Jan 10, 2011

MunoRN, what exactly are you suggesting? Am confused:confused: Are you suggesting that American nurses sign up for spanish classes??? And who pays for these classes? What about the CNAs and doctors caring for OP's patient? Are they also required to learn spanish?

carolmaccas66, BSN, RN · Jan 10, 2011

I got told at one hospital, not to use the language facilities too much as it cost $100 AUD per hour for an interpreter, but the interpreter didn't earn that much. Most of the cost went in fees to the business using the interpreter. So I suppose that's another reason why nurses may not use interpreters and language lines so much.

MunoRN, RN · Jan 10, 2011

MunoRN, what exactly are you suggesting? Am confused:confused: Are you suggesting that American nurses sign up for spanish classes??? And who pays for these classes? What about the CNAs and doctors caring for OP's patient? Are they also required to learn spanish?

If the hassle you face in dealing with language barriers makes learning a new language less work than the hassle itself, then it might be worth considering. Where I work, we can sign up for different levels of Spanish and Russian classes, we are paid for the time spent in class (with matching funds from the Union) and the class time is taken off of our floor time, so you don't end up working extra hours because of the class. Nobody is required to take a class. About half our CNA's already speak Russian, and most of our Docs already speak Spanish.

carolmaccas66, BSN, RN · Jan 10, 2011

If my facility paid for me to do languages I would definitely do it, that is for sure.

I already pay so much for ongoing education, it's not funny. I've spent $10,000 or thereabouts what with moving and living/car expenses, etc. And that isn't even factoring in university costs

NurseAdida · Jan 10, 2011

If the hassle you face in dealing with language barriers makes learning a new language less work than the hassle itself, then it might be worth considering. Where I work, we can sign up for different levels of Spanish and Russian classes, we are paid for the time spent in class (with matching funds from the Union) and the class time is taken off of our floor time, so you don't end up working extra hours because of the class. Nobody is required to take a class. About half our CNA's already speak Russian, and most of our Docs already speak Spanish.

It's a totally different story if your facility is paying for the classes. Unfortnately a lot of people don't have that extra money to pay for Spanish classes.

It's hard to please everybody. At one point or another yo will encounter a patient who does not speak your language. Doesn't make you a bad nurse at all and you are not obligated to learn that particular language to prove that you are a good nurse.

My aunt speaks only french. I would not expect English speaking nurses to be fluent in french!

tntrn, ASN, RN · Jan 10, 2011

All Japanese students are taught English, so yes you could expect that English be spoken to you.

Kids in Taiwan "learn" English too, but I can tell you from the four years my husband was based there with his airline, it's not always intelligible and it certainly wouldn't be considered fluent.

tntrn, ASN, RN · Jan 10, 2011

Where I work, we can sign up for different levels of Spanish and Russian classes, we are paid for the time spent in class (with matching funds from the Union) and the class time is taken off of our floor time, so you don't end up working extra hours because of the class. QUOTE]
You must not have a problem with staffing like most facilities do. It would be hard to imagine the uproar our administration would raise if we even suggested such a thing. We have a hard enough time getting paid time off to take medical CE classes. There must be more nurses than you can shake a stick at where you are!

GRUNGE · Jan 10, 2011

I work in a border town hospital and fine this is a common statement made to me. I catch even more remarks because i have a spanish sir name. I have spoken english my whole life and have no desire to learn spanish. It is benificial for nurses to learn spanish as it is a growing language in the country, but it should not be expected. Just as i would not expect germans to speak english if i moved there.

Bortaz, MSN, RN · Jan 10, 2011

The ANA's position on anything and $1.00 will get you a cup of coffee ...

What? Where?!

DoGoodThenGo · Jan 10, 2011

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?

No, people who pack up and "immigrate" to this country should damn well learn to speak English. If they had bothered with entering the country properly, that little requirement would have been made clear to them.

Please don't give me that nonesense about "accomodating" new arrivals to the USA. Persons have been coming to these shores from all over the world for hundreds of years, many of whom didn't speak a word of English, however it soon dawned on them to get ahead they would need to and they began to study in earnest.

Many of my friends are from familes in both NYC, Chicago, New Orleans, and so forth that are only perhaps third or fourth generation (if not second or first), that came from Italy, Poland, France, Russia,Germany and other places in Europe. All learned to speak English well enough to get on, and made sure their children did better than that via school. Yes, these parents often wanted to "protect" their heritage, but understood that to speak and understand English was the only way to suceed on these shores.

Children are quick to pick up new languages. Schools back then public and even religous didn't molly-colldle a child because he just arrived from "the old country". For the first few weeks he or she may have been assigned an "angel" or given special help, but by the end of the school year that child was expected to have command of English. Have heard stories of schools run by Polish nuns in Chi-Town who took their job to make little "Americans" out of "green-horns" very seriously.

It amazes me when some 70 year old or so Hispanic person shows up in an ER or other situation requiring interaction with a government agency/system and does not speak English. So you ask how long have they been in the USA? The usual response is "oh since she was a child". It's not they cannot speak English, but they choose not to, so why should everyone jump through hoops? Not picking on Spanish speaking persons, but am just saying. When I am in France I don't expect the clerk at the Metro station to speak English.

Bortaz, MSN, RN · Jan 10, 2011

It amazes me when some 70 year old or so Hispanic person shows up in an ER or other situation requiring interaction with a government agency/system and does not speak English. So you ask how long have they been in the USA? The usual response is "oh since she was a child". It's not they cannot speak English, but they choose not to, so why should everyone jump through hoops? Not picking on Spanish speaking persons, but am just saying.

Exactly right. Here in S. Texas, we have store/restaurant employees (as well as a large portion of our housekeepers at my hospital) that do not understand English. Quite often they have lived in the USA for decades. There really is no excuse for it.