I'm currently a peds home health nurse and met with the parents of a client I might me working with. The parents have had bad experiences with foreign nurses mainly from African countries due to their accents. All through the meeting the parents kept mentioning how much they want a nurse who speaks clear English. The parents have had difficulty with communicating with these nurses that have led bad consequences. I have empathize with the parents but at the same time feel sorry for those nurses whom English is hard to understand.
I have worked with nurses and docs who were foreign with thick accents and know how challenging it can be, I can imagine how frustrated the parents may be.
Communication or lack of is a major issue amongst healthcare personnel and according to Joint Commission(JC); it is one of the leading cause of healthcare related errors ranging from medications, plan of care, wrong site/wrong surgery, etc. Hence, communication is one of the National Patient Safety Goals(NPSG).
Majority of the healthcare personnel involved in the cases spoke english and US educated; therefore foreign trained or healthcare workers with "thick" accents are not the problem. If one does not understand what's being said, politely ask the person to repeat what he/she is saying or repeat back to ensure what you heard is actually what was said(verbal/telephone read back).
Secondly, I'm from Nigeria but obtained my high school diploma, college and graduate degree in the US. I've worked with nurses and physicians from various background and countries, I've found that sometimes just listening attentively before trying to format a reply really helps. Additionally, I've worked with "American" nurses that spoke english and had difficulty understanding what they were saying.
I could go on and on but let me stop. Let us all remember that Listening is a skill, if you don't understand what someone is saying, politely ask the person to repeat or clarify. This works better that ridiculing someone for something he/she has no control over.
But may I ask, what happens when you have to keep saying, politely: excuse me, pardon me, excuse me? It gets embarrassing and tiring having to ask someone to constantly repeat him/herself. And then you STILL can't understand them. And when u complain to management (as a group of nurses I knew did re a certain unintelligible doctor), management don't do anything cos they probably need the dr and they don't want to start a racial war.
I had an old guy once who a foreign dr was going to perform cardiac surgery on. The dr went thru all the surgical options and the consent form was signed. The old guy was nodding throughout. When the dr left, this old guy said to me: 'I didn't understand a word he said, what was he going to do to me?' There is no way that dr would be doing surgery on me, I can tell you that. And thick accents do cause major miscommunications in my experience.
I absolutely cannot understand one of the docs I work w/ on the phone. When we are face to face, it's easier to understand him. This problem was solved by sending him a text message when requesting new orders. There is no doubt about the order, because it's on my phone.
Specializes in Mental Health, Medical Research, Periop.
Many people say I have a southern accent too. I find that so funny because I never been down south before. Off topic but you minded me of that.
LoL!! That's funny you say that. I didnt think I had a strong "southern" accent until I moved to the DC area. I am from Virginia, but only minutes from Elizabeth City, NC. People keep asking me if I'm from Mississippi, or Alabama. I am like "no, I am from VA." With that they reply, "Va is right around the corner." Than I say, "No not that part of VA, about 4 hours away from here." But they don't get it, because they usually look at me with a puzzled look.
LoL!! That's funny you say that. I didnt think I had a strong "southern" accent until I moved to the DC area. I am from Virginia, but only minutes from Elizabeth City, NC. People keep asking me if I'm from Mississippi, or Alabama. I am like "no, I am from VA." With that they reply, "Va is right around the corner." Than I say, "No not that part of VA, about 4 hours away from here." But they don't get it, because they usually look at me with a puzzled look.
Well I grew up in columbia, md so I don't see how I can possibly have a southern accent. I wish I did, I love southern accents.
Well I grew up in columbia, md so I don't see how I can possibly have a southern accent. I wish I did, I love southern accents.
Coming from MD you likely DO have what most people (who aren't from the deep south) interpret as a southern accent! I grew up in MD and have heard this all over the country.
When I moved from TX back to the midwest (not known for their delightful nasal rambling), I got a lot of ribbing about sounding like I was from TX (which I loved- glad I didn't sound like something from the movie "Fargo" :)). I'd rather sound like I was from somewhere - ANYWHERE- besides here
Concerning the question of health care workers with strong accent:
I had the recent experience of a telephone consult with an RN from my insurance company regarding my diabetes management. She had a very strong accent. The information she was imparting as well as the questions she was asking were important and as this was the initial interview it was extensive and detailed.
Her accent made it very difficult to be sure of what she was asking as well as what she was advising. I did continuously ask her to repeat herself, blaming it on "poor cell phone connection" as it became embarassing and uncomfortable after a while to ask for so many repeats. What I was able to understand of her information was quite thorough and she seemed knowlegable. However, after about 30 minutes of conversation I was actually mentally tired from the effort and ended the conversation without asking some questions I would like to have pursued further.
Concerning the question of health care workers with strong accent:
I had the recent experience of a telephone consult with an RN from my insurance company regarding my diabetes management. She had a very strong accent. The information she was imparting as well as the questions she was asking were important and as this was the initial interview it was extensive and detailed.
Her accent made it very difficult to be sure of what she was asking as well as what she was advising. I did continuously ask her to repeat herself, blaming it on "poor cell phone connection" as it became embarassing and uncomfortable after a while to ask for so many repeats. What I was able to understand of her information was quite thorough and she seemed knowlegable. However, after about 30 minutes of conversation I was actually mentally tired from the effort and ended the conversation without asking some questions I would like to have pursued further.
And that is just a phone conversation...a one time encounter. The OP is working for a home health agency. I think they have every right to ask for someone they can understand in the presence of their own home. It is much different to be tolerant in an office, at the bedside or over the phone when contact is limited...but in your home on an everyday basis??
Communication or lack of is a major issue amongst healthcare personnel and according to Joint Commission(JC); it is one of the leading cause of healthcare related errors ranging from medications, plan of care, wrong site/wrong surgery, etc. Hence, communication is one of the National Patient Safety Goals(NPSG).
Majority of the healthcare personnel involved in the cases spoke english and US educated; therefore foreign trained or healthcare workers with "thick" accents are not the problem. If one does not understand what's being said, politely ask the person to repeat what he/she is saying or repeat back to ensure what you heard is actually what was said(verbal/telephone read back).
Secondly, I'm from Nigeria but obtained my high school diploma, college and graduate degree in the US. I've worked with nurses and physicians from various background and countries, I've found that sometimes just listening attentively before trying to format a reply really helps. Additionally, I've worked with "American" nurses that spoke english and had difficulty understanding what they were saying.
I could go on and on but let me stop. Let us all remember that Listening is a skill, if you don't understand what someone is saying, politely ask the person to repeat or clarify. This works better that ridiculing someone for something he/she has no control over.
I'd like to address your last comment first. I don't believe that anyone here has ridiculed anyone for having an accent. Having an accent IS something that can be controlled, IF the person that has it wants to and works at it.
Poor communication or lack of communication in all forms is a well known patient safety issue; hence, the push for EMR throughout all healthcare facilities. I do not accept, however, that thick accents are not part of the problem. I have personally had great difficulty at times with certain doctors giving phone orders and have had to have them repeat themselves several times. It was so bad with one doc that I finally refused any further phone orders because I just could not be certain that I had heard him correctly.
While someone who was born in another country can grow up in the American education system, learn English, and be well understood, that does not mean that this is the case for everyone. I have known people who have retained an accent to the point of not always being understood even though they have had a good deal of education in the States. Also, when it is said that someone is "educated" in the United States, that can mean anything from starting Kindergarten here and going through post-grad school, to getting only his/her college or higher education here.
I agree that listening is a skill that many people can improve upon, and even those who speak without an accent (to the listener's ear) may still need to repeat themselves on occasion. But it is critical in healthcare that we get it right the first time to prevent harm to those to whom we are responsible, so our patients come first. I'm sorry if nurses with an accent get their feelings hurt, as I'm sure this is not the intent, but they must accept that their patient's safety and care are their priority, and political correctness has no place in the issue when this is the case.
The bottom line is that the patient in the OP's scenario is the priority, and the parents are correctly advocating for their child, as should ANY nurse who is involved with this patient's care.
I do not think that requesting a nurse that can speak English intelligibly is unreasonable. Germany does not allow foreign nurses to obtain licenses in their country unless the nurse can demonstrate a strong command of german, including the accent. The theory is that no patient should have trouble understanding what the nurse is saying and I agree.
We, as a country, have been too lenient with this requirement and it isn't fair to the patients.
Let me clarify my statement about ridicule. I didn't say nurses on the website were ridiculing anyone . But I have had experiences of nurses making fun of colleagues accent.
I agree with you, patient safety should be priority and not be jeopardize. Every patient and his/her family has the right to seek and demand best care for their loved ones.
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LoL!
carolmaccas66, BSN, RN
2,212 Posts
But may I ask, what happens when you have to keep saying, politely: excuse me, pardon me, excuse me? It gets embarrassing and tiring having to ask someone to constantly repeat him/herself. And then you STILL can't understand them. And when u complain to management (as a group of nurses I knew did re a certain unintelligible doctor), management don't do anything cos they probably need the dr and they don't want to start a racial war.
I had an old guy once who a foreign dr was going to perform cardiac surgery on. The dr went thru all the surgical options and the consent form was signed. The old guy was nodding throughout. When the dr left, this old guy said to me: 'I didn't understand a word he said, what was he going to do to me?' There is no way that dr would be doing surgery on me, I can tell you that. And thick accents do cause major miscommunications in my experience.