Texs

pepperlady: go back up the string as we have discussed your point; if you do not see the difference relative to your point and the broader context within which this issue presents a greater communication problem, i can't help you understand it. suffice it to say, if the patient says there is a communication problem then there is a problem; care providers serve the patient first and last. i am finished with this discussion.

thank you nurse4years, i think you get it. true, we can learn from everyone, but patients who are sick, scared, worried; don't think they are in the learning mood. i have seen patients unable to communicate with nurses due to heavy accents, and they were scared. i have written down the wrong information during report due to that very accent, and have watched doctors frustration trying to communicate with these nurses. these nurses were wonderful, caring, competent people, but the lack of communication brought chaos, confusion, and was very detrimental to patient care. administration had to pull a few of these nurses from the floor and they spent days trying to improve their english. it isn't about being politically correct. it is about communication.

Altus bulldog and others: This whole discussion has drifted from its original topic and apparently the salient point of the discussion is getting lost. Let me put it this way, for example, were I to go to work in France I would not expect everyone to learn english to accomodate me. I would expect that the burden would be on me to learn French proficiently enough to be able to effectively communicate with those in my care. We are a multicultural country, thank God, but we are an english-speaking country and thus it is necessary to competently speak english. It is unfortunate that some people have to trot out the "race" card in order to deflect the conversation from the topic at hand. Simply put, the patient has the right to understand and be understood relative to his or her caregiver as that is an essential part of delivering good and safe care to the patient. If you want to work in this country (or reside here) do as our ancestors did and learn english because if you do not you are putting yourself at a disadvantage in general, and specifically, in the workplace.

Iantueno: I am not suggesting that you or anyone else assimilate anymore than you want to as members of the U.S. workforce; what I AM saying is that care providers and patients must be able to communicate period. All of the other issues you cite are not important. The only issue here is CAN YOU COMMUNICATE with your patients and vice-versa? If you do not speak the english language well enough to communicate with your patients then you need to remediate or risk degrading the quality of care you and your facility are providing to the patients. You can speak however you want to outside of work but when you are providing care you owe it to your patients to provide the best care you can.

No, I am not suggesting that patients should not speak up, I am suggesting that they should not HAVE to do so because they cannot understand the caregiver.

Madam: Some of the very nurses about whom I speak were educated in U.S. nursing schools but cannot speak the language with the proficiency required to deliver quality healthcare to their patients; this issue is a matter of degrees and invoking a Southern U.S. accent to make your point is not very persuasive. I am sure that those of you not from the South all speak the King's english and can be understood everywhere, however, I repeat, it is a matter of degrees. I have not heard a patient complain about not understanding a Southern accent but I have heard them complain about foreign-born nurses and I do not assume the patients are automatically prejudiced when they make such a complaint but assume the patients have a genuine interest in knowing they can understand their caregiver and be understood by him or her. In addition, a nurse who does not speak understandable english often undermines a patient's confidence in his or her ability to deliver quality care irrespective of that nurse's compentency.

ECKpowers: As a patient if you have to constantly ask someone else to help you because you cannot understand your care provider that will only exacerbate the existing nursing shortage (and short-staffing) in healthcare facilities.

Some foreign nurses are competent in delivering care to patients, however, a prerequisite to practicing nursing in this country (the U.S.) and to being a fully competent nurse is to have a facility with English such that patients and staff can understand you. Not only does a nurse's language deficit interfere with providing competent care to patients (and the patients should be the primary concern) it potentially creates legal liability for the nurse and the facility. For example, there was a fairly recent legal case in which a physician who failed to provide a sign language interpreter to a hearing-impaired patient was sued and damages were awared, including punitive damages, because the patient could not understand the physician and therefore could not successfully participate in decisions about her treatment. You may think citing this case (brought under the ADA) is a stretch but consider that patients do have a right to understand their healthcare providers in order to participate in their own treatment. Those nurses who have marginal facility with English need to remediate and improve their language skills or practice somewhere it is not an issue; frankly, it amazes me that some of the foreign-born nusrses with whom I have interacted even got through nursing school as they could not have met the English requirement to have done so, or, in the alternative, the standard is VERY low in order to pass and get a credential. Again, some foreign nurses are very good healthcare providers and care deeply about their patients, however, good communication between patient and care provider is such an essential element in delivering quality care that ignoring its importance puts patients, providers, and facilities in peril. Finally, I agree with the nurse who said that foreign-born nurses should not speak in their native language in the workplace (in front of others who do not speak their language) as such behavior is unprofessional and just plain rude; in addition, I agree that it is not the patient's problem that we have a nursing shortage and must hire people to provide care whom the patient cannot understand.

Hello all, I took the NCLEX-PN yesterday and found out this morning I passed; I am in MN where you can get your results very quickly by just going to the Board of Nursing website (where you had to register in the first place to take the exam) before registering with PerasonVue (who will charge you to get your unofficial results earlier than getting them through the mail). I was concerned b/c the computer stopped at around 85 (I thought it was beyond that but I think it was at 85) so I did not know if that was good or bad but it turned out it was okay. Now I just have to find a job (I hope to return to my native Texas) so on the hunt I go. Good luck to all. TEXS

By the way, I am not in TX but sort of in the Northwest, I am from Texas originally thus the handle, TEXS. TEXS

I think the results are posted on the BON (Board of Nursing) website within a couple of days so there is no reason to pay Pearson for "quick results" as there results are not even official. Maybe it it is different where you live but classmates have told me the results get posted fairly quickly here so I am just going to keep checking the BON website and hope for the best. TEXS

My test stopped at around 95 I think so I do not know what to think. Any thoughts? TEXS

Thanks for the advice regarding Excelsior; I just am not sure how to proceed but would like to get there as quickly as possible so I need to do some more research. I think once I have a job as an LPN perhaps I can find some help from those with whom I work in order to prepare for clinicals or to find preceptors. I am hoping to find a position in TX but am currently living in MN so once I know I passed the NCLEX I can start looking in earnest. By the way, if the machine stops beyond 85 on the NCLEX--PN, say at around 95 or so, does it mean you did not pass? Thanks again, Texs

THANKS for the information; your sister's experience does indeed sound unfortunate and the person with whom she dealt a bit suspect. I just learned that the (Excelsior) clinicals can be difficult to pass unless the student has had the opportunity to gain experience in a real-life setting. In addition, the clinical testing is only done in a few places throughout the country and the waiting period to be scheduled for testing-out can take a long time. I will have to think hard about going forward with Excelsior and I thank you for taking the time to give me the heads-up. The only other online option I know of is ISU and I am still getting info. about them. Regards, TEXS

I think Nurse2B gave you good advice about getting an approval in writing, however, I would add that you need to get that approval from someone who has the authority to give it, that is, a BON member and not just a secretary, etc. In addition, I should think if you are once given approval the BON in that state cannot withdraw that approval (barring any material change in the program that would cause it to fail to meet the BON requirements) and if they did do so you could probably be "grandfathered' in and your license would probably remain valid in that state. When you send the letter of inquiry to the BON or whomever else (and keep a copy for your records) I would send it certified mail and get a receipt for same. Another suggestion would be to contact the appropriate state legislator(s) and pose the question to them and try to get a definitive answer from someone else who may have knowledge and information regarding this matter; again, get it in writing. I hope this helps; perhaps others have other suggestions that would be helpful. Let us know what you learn from the BON or others relative to this matter. Regards, TEXS