"You're gonna need to learn Spanish...."

[smkiya, BSN, RN]

I'm a new RN, just started orientation last week. I met with my preceptor on the floor for the first time a few days ago and he made the comment, "Working here, you're gonna need to learn Spanish". I was only on the floor for a couple hours for a 'tour' but my preceptors pt needed assistance so I went in to help.

The patient only spoke Spanish and we had to provide care that was very messy, uncomfortable, and embarrassing for the pt. There ended up being 3 of us in the room to try and resolve the problem but it wasn't going well. The pt had tears in her eyes and I wanted so badly to provide comforting words and reassurance, but couldn't. All I could do was look softly into her eyes and stroke her hair, meanwhile feeling like a total failure because I couldn't communicate with her in her time of need.

There wasn't time to use the language line, my preceptor only spoke a couple words, and the other nurse didn't speak Spanish either. For 45 minutes we turned and cleaned only to have to turn and clean, it was terrible. I'm sure she had no idea what we were doing, she was exposed, and no one could tell her anything. All I kept thinking was why wasn't the need to learn Spanish emphasized before now. Sure I've had Spanish patients during clinicals, but I usually had a classmate who was fluent or I used the language line. I had every intention of learning Spanish in the future because I knew it would be beneficial... but now I'm going to do everything in my power to learn it as quickly as possible because I NEVER want to go through that experience EVER again! I had to do everything in my power to keep my tears at bay while silently comforting the pt. Even now as I write I try to avoid imagining myself or a family member in her situation.

Has anyone else had an experience where they felt so strongly about wanting to learn a language? Or, did you learn a language and have a situation where you were so happy that you did?

Thanks for listening....

[Tweety, BSN, RN]

You actions communicated your compassion, I'm sure she understood. Don't be so hard on yourself. You did a great job.

[KellNY, RN]

Why was there no time to use the language line? It's a PITA, but really only takes a few moments,and from what you describe, could have made a HUGE difference in the quality of care provided to this Pt.

Not trying to sound harsh or anything, but ethically, it should have been accomodated, as I'm sure your hospitals Pt Bill of Rights says something about the right to have all procedures explained to you in the language that you are most comfortable with.

Personally-I'm trying to learn as much Spanish as I can without taking any formal classes (as I don't have the time or flexibility of schedule to commit to that right now, unfortunately). I try to use the language line whenever it's not an emergency. I try to schedule Pt care for when I know the significant other or a trusted friend who is bilingual will be present.

I love your approach, that this isn't a "Why should I be expected to learn their language?". You seem very compassionate and caring, and that's excellent. It will get you far in the hearts of your pts. It sounds sappy, but I'm serious.

We have a nurse on our unit who has said "I refuse to learn ONE word of Spanish. This is America, they chose to come here, let them learn some English" She also refuses on Language Line (unless a doc requests it). So I'd really like to know how she completes her assessments.

Keep in mind, though, that even if you become fluent in Spanish, you'll still run into this situation from time to time. In the past month, I've had Pts who speak only Mandarin (chinese), Turkish, and one who spoke Urdu, Farsi, Hindi but not a word of English.

And Re: Language Line-FYI (and I didn't know this until recently)-most hospitals are equipped so that you can use the regular phone in the Pt's room, and call the operator and let her know you need to be connected to spanish LL translator. You'll be on hold a few min, and the operator will give LL all the info--account number, all that.

[TazziRN, RN]

I'd better stay out of this one, I'll get flamed

[Midwest4me]

What's a "language line" and what's PITA?????

[TazziRN, RN]

PITA = Pain in the a**

Language Line: a service set up by telephone with a translation service...they can usually find a translator for almost any language you might encounter

[smkiya, BSN, RN]

With regards to the language line I'll try to explain, but due to HIPPA I won't go into too many details.

This pt required a new ostomy wafer and bag because the integrity the other had become compromised. She and the bed was soaked with loose stool and she was on contact precautions. It took several minutes to remove the adhesive on her already delicate skin while having to continually clean the area because of continuous streams of loose stool. We tried to avoid using stomahesive paste to protect her skin because there were areas of irritation, but were unsuccessful in securing a bag after two attempts. We were finally able to resolve the problem but it took some time. We all went through several pairs of gloves, chucks, linen, and gowns before everything was under control. The patient was unable to move on her own which is why this process required 3 people. So with the combination of the patient drenched in uncontrollable loose stool, all of us turn and holding her in position, gathering equipment and cleaning to try to stop the flow on a patient on contact precautions as much as my heart would have wanted it, we just couldn't use the language line.

[PeachPie]

I live in Houston, and I have become a master of pantomiming, sketching, broken Spanish, and gestures. I took some Spanish, but once you know one Latin-derived language language, or at least a grasp of the roots, it's easier to understand. You'll pick up. There are dictionaries of medical-related Spanish out there that are a great help.

My pet peeve: Ok, I won't begrudge you for not learning English, at east not at the moment. You're in the hospital, and there's not much that we can do about that right now. What I can't stand are ethnocentric people who keep rapidly jabbering on in their language even though it has been established that I don't understand. Yeesh, they say that we Americans are recalcitrantly ethnocentric and think that speaking more loudly is going to make others understand. They can try to simplify it, speak more slowly, pantomime, or say one word at a time until we'll stumble upon one that I'll understand.

When I went to China, I only knew a few words of Mandarin. However, I carried a bilingual dictionary at all times, which greatly assisted me.

[Euphrosyne7, MSN, RN]

Hi:

I completely know how you feel. Where I am, there is a huge majority of patients who speak only or mostly Spanish. I have been trying my best to learn spanish, at least to the degree of being able to communicate somewhat. If it is an initial assessment, etc, I will get a translator; however, for continuing care, I have picked up Medical Spanish made incredibly easy. I find that this book has many of the phrases needed to communicate at least to a degree with Hispanic clients.

I cannot stand not being able to communicate with my patients so I have made it a personal goal to learn at least enough spanish to do so. Also even if you start off slow like just using common phrases, such as Hello, my name is ......, and I am your nurse today......How are you...., it reinforces it in your mind so you then can put together more and more. I was getting so good at saying these basic phrases that my patients thought I was fluent and started talking rapidly about something...then I had to kind of indicate I can only speak/understand a little bit....but they actually seemed to appreciate even that. When I had a clinical, I followed around a NP who I thought had taken classes she spoke Spanish so well, but she told me that she had learned it all on the job and just kept learning new phrases and she was doing her assessments and everything in Spanish. Now I am getting better and hopefully at some point will be good enough to do an entire assessment without the help of an interpreter. Good luck!

p.s. I STILL don't know if I passed the NCLEX yet!!!

[CaLLaCoDe, BSN, RN]

Sorry to be the controversial one. But wake up! These folks are in a country where English is the standard preferred language. And, it's not my responsibility to spend my free time learning a foreign toungue.

If you're in the hospital and you only speak Spanish, get a family member who speaks English to help translate for you!

Don't correct me on my use of your Spanish language! I'm trying the best that I know how to communicate with you!

Excuse me! You're the one who insists on using your language to communicate with me, when I know you've spent at least a little time here and have some brief understanding of English and can trouble yourself to speak in English...this is not MEXICO!

[TazziRN, RN]

sorry to be the controversial one. but wake up! these folks are in a country where english is the standard preferred language. and, it's not my responsibility to spend my free time learning a foreign toungue.

if you're in the hospital and you only speek spanish, get a family member who speaks english to help translate for you!

don't correct me on my use of your spanish language! i'm trying the best that i know how to communicate with you!

excuse me! you're the one who insists on using your language to communicate with me, when i know you've spent at least a little time here and have some brief understanding of english and can trouble yourself to speak in englsih...this is not mexico!

yes!!!!!!!!

thank you, thank you, thank you!!!!

[CHATSDALE]

what is the hippa concerns about using a third party to communicate

i am sure that if the woman had a colonostomy bag she would know that these accidents do happen and i know that she was grateful for the assistance